Provider Demographics
NPI:1861660268
Name:INTERMOUNTAIN HEALTH CARE
Entity type:Organization
Organization Name:INTERMOUNTAIN HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NNP
Authorized Official - Prefix:MISS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:TATTON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:801-232-0600
Mailing Address - Street 1:100 N MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84113-1103
Mailing Address - Country:US
Mailing Address - Phone:801-662-4100
Mailing Address - Fax:801-662-4166
Practice Address - Street 1:100 N MEDICAL DR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84113-1103
Practice Address - Country:US
Practice Address - Phone:801-662-4100
Practice Address - Fax:801-662-4166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren